Shelter and Services Program Application Worksheet.xlsx
XLSX spreadsheet 385 KB Posted
- Attached to
- Fiscal Year 2023 Shelter and Services Program Federal grant opportunity
- Opportunity number
- DHS-23-GPD-141-00-99
- Issued by
- Federal Emergency Management Agency
About this file
Shelter and Services Program Application Worksheet.xlsx
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Introduction
FY 2023 Shelter and Services Program (SSP) Application Worksheet Introduction
As part of the FY 2023 SSP application process, applicants must complete a formal application worksheet that addresses the evaluation criteria specified in the NOFO and provides additional information and certifications. SSP is authorized in the Consolidated Appropriations Act, 2023 (Pub. L. No. 117-328).
The Federal Emergency Managment Agency (FEMA) has developed guidelines that help ensure that submissions are organized in a consistent manner while addressing key data requirements. This application worksheet must be used by applicants to complete and submit their application. Failure to address these data elements in the prescribed format could potentially result in the rejection of the application worksheet from review consideration.
Applicants that are applying with subapplicants known at the time of submission must ensure their applications are inclusive of all subapplicant information that they wish FEMA to review and must be submitted by the deadline. All applicants are encouraged to review the FY 2023 SSP NOFO for details on the application submission process. Applications will be submitted through FEMA's Grants Outcomes (FEMA GO) System. Applicants should use this worksheet to prepare their application materials and as a reference guide throughout the application process. All pre-application materials, including this worksheet, should be completed prior to beginning an application in FEMA GO.
| Tab 1: Certifications |
| This tab must be completed by the applicant and used as a worksheet to be review/confirm the required certifications for the SSP application in FEMA GO. Each applicant needs to sign the applicable certifications by marking an "X" in Column B next to each certification. |
| Tab 2: Budget Summary |
| This tab provides only instructions for entering primary and secondary costs into FEMA GO, i.e., all information is entered directly into FEMA GO, not in this worksheet. Due to system limitations, budget summary line items have field names in FEMA GO that are different from the primary and secondary cost terms that are defined in the Notice of Funding Opportunity (NOFO). This tab provides an explanation of the terms used in the FEMA GO system. |
| Tab 3: Subapplicant Info |
| This worksheet collects necessary subapplicant information. Only those applicants with subapplicants known at the time of application submission need to complete this section. |
OMB No. 1660-0158 Expiration: 12/31/2023
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this data collection is estimated to average 36 minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting this form. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street. SW, Washington, DC 20472-3100, Paperwork Reduction Project (1660-0156) NOTE: Do not send your completed form to this address.
PRIVACY NOTICE
GENERAL: This information is being collected for the primary purpose of determining eligibility and administration of SSP and to ensure compliance with existing laws and regulations regarding SSP.
AUTHORITY: The collection of this information is authorized by the Consolidated Appropriations Act, 2023 and 2 CFR Part 200.
USES AND SHARING: FEMA will not share the information collected from POCs, including personally identifiable information, outside of the collecting agency. Further information regarding FEMA’s use and sharing of information can be found within the DHS/FEMA/PIA-013 Grant Management Programs Privacy Impact Assessment. The Department’s list of Privacy Impact Assessments can be found on the Department’s website at https://www.dhs.gov/privacy-impact-assessments.
EFFECTS OF NONDISCLOSURE: The disclosure of information on this form is voluntary; however, failure to provide the information requested may delay or prevent the organization from receiving grant funding.
End of Sheet
&G
Tab 1 Certifications
| SSP Application Information |
| Applicant Name: |
| Applicant UEI: |
| Facility address(es) where services will be provided to noncitizen migrants: |
| To add more facilities, right click row 11 in the worksheet and select "Insert row" as appropriate | Street (List facility address where services will be provided to noncitizen migrants) |
| (e.g, 123 Main Street, Suite 456) | City |
| (e.g., Springfield) | State |
| (e.g., Missouri) | Zip Code |
| (e.g., 12345) | County |
(e.g, Brown)
| Facility 1 |
| Facility 2 |
| Facility 3 etc. |
SSP Application Certifications Enter "X" to verify.
Specify the process on Step 4.
| 1. I certify that all entities represented by this application have internal controls and processes in place to clearly identify migrants who have been processed and released from DHS apart from other populations served. |
| 2. I certify that all entities represented by this application are only providing services funded by the SSP to noncitizen migrants within 45 days of their release from DHS custody. |
| 3. For reimbursement funding: I certify that all entities represented by this application have verified status and release dates of served noncitizen migrants by Alien Registration Number (A-number) or evidence of DHS processing (e.g., I-94, I-385, I-860, I-862) for any A-numbers being submitted with this application. |
| 4. For advanced funding: Specify the process below by which all entities represented by this application will collect and track A numbers or evidence of DHS processing (e.g., I-94, I-385, I-860, I-862) and release dates for all noncitizen migrants served by SSP funding. |
| Please specify the process for Certification #4 here: |
End of Sheet
Tab 2 Budget
| FEMA GO Budget Summary Entry Instructions | |
| I. Applicant Information |
Primary and secondary service costs must be entered into FEMA GO. However, due to system limitations, budget summary line items have field names in FEMA GO that are different from the primary and secondary service categories that are defined in the Notice of Funding Opportunity (NOFO).
The following crosswalk and guidance are supplemental to the FEMA GO instructions listed below and should be referred to only when an applicant is entering in their budget information into FEMA GO. Please note that construction costs should be entered normally according to FEMA GO guidance without any alterations. The instructions below refer only to non-construction costs.
All secondary services will be grouped under “Other” and must specify the relevant allowable activity category in the “Project Name” and “Project Description” in Step 3. See Appendix A of the NOFO for allowable activity categories (such as "Outreach information" or "Clothing," etc.).
FEMA GO Instruction link: https://www.fema.gov/grants/guidance-tools/fema-go/startup
Table 1: Crosswalk
Primary Services (NOFO service category) Primary Services (FEMA GO Term)
| Shelter | Contractual |
| Food | Equipment |
| Transportation | Fringe Benefits |
| Acute Medical Care | Personnel |
| Personal Hygiene Supplies | Supplies |
| Labor for Primary Services | Travel |
| Secondary Services (NOFO service category) | Secondary Services (FEMA GO Term) |
| Renovations/Modifications | Other | |
| Clothing | Other | |
| Outreach Information | Other | |
| Translation Services | Other | |
| Labor for Secondary Services | Other | *** Please note Management & Administration is not a secondary service but should be entered into FEMA GO as a secondary service cost. |
| Mangement & Administration *** | Other *** |
II. How to Enter Primary Services Costs into FEMA GO
Step 1. Please select “No” in the “Grant request details” section pictured below:
Step 2. Once selected, click the blue box titled "Add activity." A new dialog box will open, then select "Project" and click on the blue "Add this activity" box.
Step 3. Please then specify which primary service cost in the "Project name" field and input the "Project desciption" as appropriate.
Step 4. Once completed, select the “+ Add an item” box and a new dialog box will open with the crosswalked terms from Table 1 in the drop-down menu. Please select the appropriate primary service cost from the associated term in the drop-down menu below (e.g., “Shelter” costs = “Contractual”).
Step 5. Once selected, a new dialog box will open. Appropriately update the “Quantity” and “Unit Price” fields. The total will automatically calculate in the “Unit total” field. Once completed, then select the blue “Add this item” box.
Step 6. Please then verify that the line item is correct in the next subsection titled "Overall Budget Summary".
Once verified, repeat steps 3–6 for the remaining primary service costs referring to Table 1 to appropriately crosswalk the NOFO service categories with FEMA GO terms.
III. How to Enter Secondary Services and Management & Administration Costs into FEMA GO
To enter both secondary services and management & administrations costs into FEMA GO:
Step A. Go back to “Project activity narrative” under the “Activity: Project” section.
Step B. Click “Add an item,” and select “Other” for all secondary services. In “Description,” describe which secondary service category you are adding. For example, select “Other” and then list in the description “Outreach information” and provide a summary of the cost items as appropriate. Select “Other” for “budget class” and fill in the quantity and unit price. Select “Add this item” to include it in your application.
Once verified, repeat steps A–B for the remaining secondary service costs, referring to Table 1 to appropriately crosswalk the NOFO service categories with FEMA GO terms.
End of Sheet
Tab 3 Subapplicant Information
| Subapplicant Information | ||||
| Subapplicant | Unique Entity Identifier (UEI): | |||
| (12 digit numeric) | Legal Name of the Organization | |||
| (e.g., A1 Nonprofit) | POC Name | |||
| (e.g., John Doe) | Entity Type | Street (List facility address where services will be provided to noncitizen migrants) | ||
| (e.g, 123 Main Street, Suite 456) | City | |||
| (e.g., Springfield) | State | |||
| (e.g., Missouri) | Zip Code | |||
| (e.g., 12345) | County | |||
| (e.g, Brown) | If Mailing Address is Different than | |||
| Facility Address, Input to the right | Mailing Address | |||
| (e.g., PO Box 12345) | City | State | Zip Code | County |
| Subapplicant 1 | ||||
| Subapplicant 2 | ||||
| Subapplicant 3 | ||||
| Subapplicant 4 | ||||
| Subapplicant 5 | ||||
| Subapplicant 6 | ||||
| Subapplicant 7 | ||||
| Subapplicant 8 | ||||
| Subapplicant 9 | ||||
| Subapplicant 10 | ||||
| Subapplicant 11 | ||||
| Subapplicant 12 | ||||
| Subapplicant 13 | ||||
| Subapplicant 14 | ||||
| Subapplicant 15 | ||||
| Subapplicant 16 | ||||
| Subapplicant 17 | ||||
| Subapplicant 18 | ||||
| Subapplicant 19 | ||||
| Subapplicant 20 |
To enter more Subapplicants, right click on row 22 in the worksheet and select "insert row" as appropriate
End of Sheet
NA
| State | Entity Type |
| Alabama | State |
| Alaska | Local Government |
| Arizona | Tribal Government |
| Arkansas | Nonprofit Organization |
| California | |
| Colorado | |
| Connecticut | |
| Delaware | |
| Florida | |
| Georgia | |
| Hawaii | |
| Idaho | |
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| Puerto Rico | |
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| Vermont | |
| Virginia | |
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| Wisconsin | |
| Wyoming |
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